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Left, Baystate Medical Center's Dr. Gabriel T. Cade, of Northampton, checks supplies he uses as a wilderness medicine educator and practitioner. Right, Cade appears, in 2002, on CBS' "Survivor: Marquesas" as part of the Rotu tribe.
(Photos by John Suchocki / The Republican [left] and CBS)

Wilderness medicine is defined by the practice of medicine in resource-limited, austere environments.

Dr. Gabriel T. Cade remembers that when he was a boy, his physician father treated his “usual cuts and scrapes of boys in the Appalachian mountains” on the kitchen table of their North Carolina home, before the doctor was willing to drive for 30 minutes on the windy road to the nearest medical center.

Now 35 and living in Northampton, Cade is an emergency medicine physician and wilderness medicine fellow at Baystate Medical Center in Springfield.

He’s taking his passion for adventure and helping others, and combining them into his medical vocation.

Cade, in 2002, on CBS's "Survivor: Marquesas."Submitted

“Wilderness medicine is defined by the practice of medicine in resource-limited, austere environments,” he said. While the image of this field may be the expedition doctor on a trip down the Amazon or up into the Himalayas, it also includes work done after natural or precipitated disasters as well as in international/underdeveloped areas.

“While we as a nation continue to raise our awareness of and compassion for those that suffer around the world, wilderness medicine education specifically trains physicians to provide medical care in the absence of Western technology and support,” he said.

Wilderness medicine is a relatively new subspecialty of emergency medicine, and this is the second year of the fellowship at Baystate Medical Center. Cade has duties in the hospital as an educator, and duties outside of the hospital as a researcher and student.

He gives lectures to residents and medical students on wilderness medicine topics that are likely to be pertinent to their career in a hospital, or prepare them for potential catastrophes outside of the hospital. He participates in national conferences centered on wilderness/extreme medicine, and writes case reports and research studies for national publications.

One of the main focuses of his work is an investigation into technology in the wilderness, from the apps available on a smartphone that could save a life, to the portable solar chargers and hand-held ultrasound machines that are revolutionizing the ability to make rapid diagnoses, without an x-ray or CT scanner.

Cade doing wound care at an AIDS hospice in Zambia.Submitted

“At Baystate, much of my work this year still involves establishing the foundation for the fellowship, and how our institution will contribute to the field at large,” said Cade, who sees patients and oversees medical care too.

For Cade, the didactic foundation of studying wilderness medicine must be coupled with wilderness exposure.

“As I imagine the various scenarios, in which I may find myself through my career, it is important to me that I never become a liability in an unexpected medical situation. That is to say, one of the first rules of wilderness medicine is don’t add to the number of patients,” he said.

Cade describes his education as “a bit complicated, consistent with the frenetic mental pathology of ER doctors, but an even more torturous route than some."

He studied at several schools with various majors, but his undergraduate years were interrupted by periods of adventure, like hiking the Appalachian Trail, traveling throughout the world, and working in Sub-Saharan Africa at an AIDS hospice.

“Wilderness medicine is both a practical skill set that enhances my work as an emergency medicine doctor at Baystate, where I have treated drowning victims, lightening strikes, snakebites, heat-related illnesses, etc. as well as a means to take my strong emergency medicine training from Baystate, and apply it in an area where I can’t get a CT scan or even lab work,” he emphasized.

Involved in search and rescue training and service, Cade is a rescue-certified scuba diver, and he is studying high- and low-angle rope rescue, and swift water rescue.

“I’m fascinated by wilderness survival techniques which focus, like wilderness medicine, on getting by when you have nothing,” he said.

Married and the father of two, Cade likes to hike, camp and rock climb.

But his adventures have gone beyond what New England can offer.

“I have had quiet a few interesting episodes of exposure to wilderness adventure and medicine,” he said.

He has been rock climbing, and participated in high-altitude summits in North and South America, and participated in crevasse rescues.

“I competed on the reality show ‘Survivor Marquesas,’ during which members of my ‘tribe’ suffered from parasitic infections, severe lacerations, dehydration and malnutrition, sea urchin envenomation, moray eel bites and teeth broken from coconut,” he said.

“I helped with 'Eco-challenge Fiji,' and assessed adventure racers who had made it to the top of the small island, where I had set up my camp and ropes course six days into the gruesome race. I was stuck in the middle of the Pacific Ocean when the boat I was sailing, from Los Angeles to Hawaii, lost its main sail.”

He spent a month working in an emergency department in St. Croix, and he treated people with illnesses unseen here, like Dengue; he treated four men who had been lost at sea for seven days after the engine of their boat broke.

Cade climbs Washington's Mount Rainier.Submitted

When Cade thru-hiked the Appalachian Trail, Cade contacted 30 prominent and independent gear companies for sponsorship, and five companies provided his clothes and gear for the four-and-a-half-month hike.

“Since then, I have continued to abuse gear for every extremity and every weather condition,” he said.

Cade spent about a year living in his car, driving throughout the western United States backpacking, climbing and mountain biking, writing for small newspapers near his home in North Carolina, and submitting reviews for the gear he used, whether it was given to him or not, in hopes of getting a foothold into more opportunities to keep living that way.

“It was an amazing and dirty time in my life; it was a time when I had absolutely no inclination that I would ever return to school,” he said.

The son of one of the first primary care doctors in rural western North Carolina, and an intensive care unit nurse who is now a chemotherapy nurse, Cade volunteered at an AIDS hospice in Zambia.

“I think when I was in school previously that I was afraid of choosing medicine because it always felt like something I might have been expected to do,” he said.

“I worried that I would question how true the decision would have been. It was only through this excessively circuitous path that I found myself drawn back into school at all, with medicine as a clear choice for me.”